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SEE SECTION 17 TO FIND A LIST OF THE SUPPORTING DOCUMENTATION THAT MUST BE SUBMITTED WITH THIS APPLICATION. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No. 0938-0685 Expires: 09/26 WHO SHOULD SUBMIT THIS APPLICATION Institutional providers must complete this application to enroll in the Medicare program and receive a Medicare billing number. Institutional providers can apply for enrollment in the Medicare program or make a change in thei.

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The days of frightening complex tax and legal documents are over. With US Legal Forms the whole process of completing official documents is anxiety-free. The best editor is right at your fingertips supplying you with a wide range of advantageous instruments for completing a Form CMS-855A Medicare Enrollment Application. These tips, together with the editor will guide you with the complete process.

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